移位髋臼骨折合并骨盆后环损伤的手术治疗  

Surgical treatment of displaced fracture of acetabulum associated with posterior pelvic ring injuries

作　　者：任中全[1] 吴刚[1] 张磊[1] 马海[1] 

机构地区：[1]营山县人民医院骨科,四川营山637700

出　　处：《西部医学》2008年第6期1172-1173,共2页Medical Journal of West China

摘　　要：目的探讨移位髋臼合并骨盆后环损伤的手术治疗方法。方法对19例移位髋白骨折合并同侧骶骨骨折或骶髂关节分离患者，根据患者病变情况，对髋臼骨折应用重建钢板和（或）拉力螺钉内固定19例，骨盆后环损伤应用支架外固定10例，骶骨棒固定2例，骶髂螺钉固定1例，骶髂关节前方钢板固定3例，骶髂关节前方钢板联合支架固定1例。结果经过1～5年随访，19例患者中疗效达优者13例（68．4％），良1例（5．3％），可2例（10．5％），差3例（15．8％）。术后并发症主要包括髋关节创伤性关节炎1例，髋臼软骨坏死2例，BrokerⅡ异位骨化1例，迟发性神经损伤3例。结论对移位髋臼骨折合并骨盆后环损伤的患者，在对髋臼骨折进行手术治疗的同时，应同期处理骨盆后环损伤，方可达到较满意治疗效果；其髋臼骨折的损伤程度及复位质量则是决定远期疗效的主要因素。Objective To discuss the surgical treatment of displaced fracture of acetabulum associated with posterior pelvic ring injuries. Methods 19 patients with displaced fracture of acetabulum associated with posterior pelvic ring injuries were operated. 19 cases were operated with internal fixation of reconstruction plate or lag screw, 10 with brace fixation, 1 with sacral bar, 2 with sacroiliac screw fixation, 3 with anterior sacroiliac plate fixation, and 1 with anterior sacroiliac plate combined external fixation. All the patients were followed up for 1-5 years. Results According to Majeed＇ s pelvic injury evaluation and Matta＇s acetabular fracture evaluation, the excellent, fine, common and poor treatment results were 13 （68.4%）, 1 （5.3%）, 2（10. 5%） and 3（15.8%）, respectively. The complications were included traumatic arthritis of the hip （1 cases）, ace tabular cartilage necrosis （2 cases）, heterotopic ossification （1 cases） and delayed nerve injury （3 cases）. Conclusions It is necessary and important to simultaneously treat posterior pelvic ring injuries and acetabular fractures for patients with displaced fracture of acetabulum associated with posterior pelvic ring injuries.

关 键 词：髋臼 骨盆 髋骨折 骨折固定术 内固定术 

分 类 号：R681.6[医药卫生—骨科学]